DEREK BRIAN WALL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

ACTIVE

Business

First Name

DEREK

Middle

BRIAN

Last Name

WALL

Suffix

Business Name

DEREK BRIAN WALL MD

Original Issue Date

05/06/2010

Effective Date

04/06/2023

Expiration Date

07/31/2026

City

PORTSMOUTH

State

Zip

03801

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/06/2023